Summary & Overview
CPT 64836: Ulnar Motor Nerve Repair
CPT code 64836 denotes surgical suturing repair of the ulnar motor nerve, a peripheral nerve procedure that addresses motor deficits affecting hand intrinsic and some forearm muscles. Nationally, this code matters because ulnar nerve injuries can cause significant functional impairment and drive utilization of specialized surgical services and post-operative rehabilitation. Key payers in typical coverage analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context about the procedure, expected sites of service, and the types of care associated with nerve repair. The publication also outlines common payer coverage considerations and benchmarks, where available, and highlights operational and billing elements relevant for surgical and hospital billing teams. Data not available in the input is noted where applicable, and the content focuses on nationally relevant clinical and coding information rather than state-specific policy.
Billing Code Overview
CPT code 64836 describes surgical repair of the ulnar motor nerve using suturing techniques. This procedure restores continuity of the ulnar motor nerve, which supplies many intrinsic hand muscles and selected forearm muscles responsible for fine motor function and grip.
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Service type: Peripheral nerve repair
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Typical site of service: Operating room or ambulatory surgical center, often performed by a hand surgeon or peripheral nerve surgeon under regional or general anesthesia.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who sustains a traumatic laceration or sharp transection to the distal forearm or at the wrist/hand resulting in loss of intrinsic hand motor function, weakness with finger abduction/adduction, clawing, or decreased grip strength. The patient presents to the emergency department or hand surgery clinic with sensory preservation or partial injury but clear motor deficit localized to the ulnar motor nerve distribution. After clinical exam and often electrodiagnostic testing or ultrasound confirmation, the patient is scheduled for operative nerve repair. The surgical workflow includes anesthesia evaluation (regional block or general), operative exploration of the ulnar nerve, debridement of damaged nerve ends, tension-free primary epineural or group fascicular suture repair of the ulnar motor branch (performed microsurgically with loupe or microscope), possible nerve grafting if gap is present (separate code), wound closure, and postoperative immobilization with hand therapy arranged for motor reeducation and monitoring for recovery. Typical sites of service are the hospital operating room or ambulatory surgery center. Usual providers include orthopedic hand surgeons, plastic/reconstructive microsurgeons, and neurosurgeons with hand specialization. Expected documentation includes operative report describing nerve identification, technique of repair (epineurial or fascicular suture), laterality, estimated blood loss, anesthesia type, and postoperative instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure is performed on the left ulnar motor nerve |
RT | Right side | Use when the procedure is performed on the right ulnar motor nerve |
50 | Bilateral procedure | Use when bilateral ulnar motor nerve repairs are performed (rare) |
62 | Two surgeons | Use when two surgeons with distinct skills concurrently perform the repair |
80 | Assistant surgeon | Use when a surgical assistant participates and documentation supports it |
22 | Increased procedural services | Use when intraoperative complexity or extended time significantly exceeds usual service |
52 | Reduced services | Use when the service is partially reduced or aborted |
53 | Discontinued procedure | Use when the procedure is started but discontinued for documented reasons |
59 | Distinct procedural service | Use to indicate a separately identifiable service on the same day when applicable |
26 | Professional component | Use when only the professional component is reported separate from technical facility charges |
TC | Technical component | Use when only the technical/facility component is reported |
78 | Return to OR for related procedure during global period | Use when a subsequent unplanned return to the operating room for a related procedure occurs |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during the global period |
XE | Separate encounter (distinct from other services) | Use when the repair is a distinct service not ordinarily reported together (Note: not in provided list; excluded) |
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Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S64.211A | Laceration of left ulnar nerve at forearm level, initial encounter | Common traumatic code when ulnar motor nerve transection in the forearm requires primary repair |
S64.212A | Laceration of right ulnar nerve at forearm level, initial encounter | Same as above for right-sided injuries |
S64.221A | Laceration of left ulnar nerve at wrist and hand level, initial encounter | For distal ulnar motor branch injuries at wrist/hand requiring repair |
S64.222A | Laceration of right ulnar nerve at wrist and hand level, initial encounter | Right-sided distal ulnar nerve laceration code |
G56.21 | Lesion of ulnar nerve, left upper limb | Used for nontraumatic or chronic compressive/lesion presentations involving motor dysfunction |
G56.22 | Lesion of ulnar nerve, right upper limb | Right-sided lesion code for chronic or nontraumatic etiologies |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
64836 | Repair, ulnar motor nerve, with suturing | Primary code for direct repair of the ulnar motor nerve as described |
64831 | Repair, median nerve, forearm and/or wrist; with direct anastomosis | Performed when median nerve injury is also present or for comparison in multi-nerve trauma |
64832 | Repair, median nerve, forearm and/or wrist; with graft | Related when nerve gap requires grafting rather than primary repair |
64718 | Neuroplasty and/or transposition; ulnar nerve at elbow | Performed for ulnar neuropathy at the elbow in staged or separate procedures |
20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa | May be used pre- or postoperatively for diagnostic or therapeutic injections in related conditions |
29848 | Arthroscopy, wrist, surgical; when wrist pathology is addressed concurrently | Performed when concomitant intra-articular wrist injury requires arthroscopic management |